NCPA Gives Another Push for Pharmacy Accreditation Exemption

ALEXANDRIA, Va. — With Senate and House leaders trying to
craft a health care reform bill to send to the White House, the
National Community Pharmacists Association has once again called
for the legislation to exempt pharmacists from DMEPOS
accreditation.

The association has been pushing hard for such an exemption from
CMS’ accreditation mandate, arguing the agency has already let 17
other medical providers off the hook but is requiring pharmacists
to undergo a “time-consuming, expensive and redundant” process
since they are already subject to regulations and fines at the
state level. NCPA officials have also said that while the
accreditation regulation is supposed to prevent fraud, there is
little evidence that pharmacists are involved.

In a Jan. 6 letter to House Speaker Nancy Pelosi, D-Calif., and
Senate Majority Leader Harry Reid, D-Nev., NCPA said the final
reform measure should “assure seniors access to essential durable
medical equipment (DME) by adopting the Senate’s proposal to exempt
from Medicare’s burdensome, duplicative accreditation requirements
those pharmacies that derive no more than five percent of total
prescription sales from DME, such as diabetes testing
supplies.”

As the October 2009 accreditation deadline approached, Congress
gave pharmacists a 90-day
extension until Dec. 31, and there are provisions in both the
House and Senate reform bills that would permanently exempt certain
pharmacies from the requirement. Even so, the NCPA is encouraging
its members — some 23,000 independent pharmacies across the
country — to complete accreditation.

So is CMS. In a late December memo, the agency said it would
continue to process accreditation determinations for pharmacies
after Jan. 1 but also noted pharmacies should complete their
applications “as soon as possible.”  Revocations for those not
meeting the requirement “will be prioritized based on any potential
beneficiary access issues as well as the agency’s workload,”
according to the memo.

The NCPA also asks that a pharmacy surety bond exemption
included in the House bill be part of the final legislation.

In other recommendations for the health reform bill, the NCPA
said it should:

• Reform the Medicaid Average Manufacturer Price (AMP)
  reimbursement system for generic drugs and adopt, at a minimum, the
  Senate’s federal upper limit of no less than 175 percent of the
  weighted average AMP. “Anything less could force many independent
  community pharmacies, which care for an extraordinarily high number
  of Medicaid patients, out of the program,” the association
  said.

• Combine House-passed transparency provisions for pharmacy
  benefit managers (PBMs) operating in the proposed health insurance
  exchange with Senate language extending the reporting requirements
  to Medicare Part D drug plans.

• Support all House and Senate-passed provisions expanding the
  community pharmacist’s ability to provide medication therapy
  management services to maximize the patient’s adherence and
  therapeutic benefit while lowering the cost of inappropriate
  prescription drug use — estimated at $290 billion
  annually.

NCPA’s letter also raises questions about how a new,
government-sponsored public option would impact independent
pharmacies, both in terms of reimbursement as well as small
business health insurance requirements; suggests alternatives to a
costly proposed mandate under Medicare; cautions against any
federal pre-emption of state-based “any willing provider” laws;
opposes moving Medicare vaccination coverage into the Part B
program; backs safeguards to prevent 340B, low-income drug
subsidies from being diverted to hospital employees and others;
seeks clarification that any provision allowing the government to
set Medicare drug prices not apply to pharmacy reimbursement; and
supports House-passed language to close the Medicare Part D
coverage gap, or “donut hole.”

“Community pharmacists are ready and willing to help improve
health outcomes and lower costs,” said NCPA Executive Vice
President and CEO Bruce Roberts, RPh, in a release. “The
recommendations we present here will make a good thing even better
for patients.”